Decision to widen access to influenza vaccine
What we’re doing
We're pleased to announce that we are widening access to influenza vaccine from 1 April 2023 for the following two groups, for the duration of the 2023 calendar year:
- Children who are 6 months to 12 years of age
- Māori and Pacific peoples who are 55 to 64 years of age.
Why we’re widening access
In 2022 we made decisions to widen access to influenza vaccine for Māori and Pacific peoples from 55 to 64 years of age and for children from 3 to 12 years of age, for the 2022 influenza season. Our clinical advisors had told us that in 2020 and 2021 there had been very little seasonal influenza circulating, due to the public health measures taken to manage the COVID-19 pandemic. They advised us that, as a consequence, this lack of circulating influenza virus was likely to have reduced the natural level of immunity in the New Zealand population, increasing the risk of severe illness from influenza. The decisions to widen access were intended to reduce the impact of influenza on high-risk populations during the COVID-19 pandemic and to reduce the impact on the health sector by reducing hospitalisations when the health sector was already under pressure managing COVID-19 cases.
In March 2022 we consulted on the proposal to widen access for Māori and Pacific peoples from 55 to 64 years of age. In addition to the supportive feedback about funding this group, we also received many responses suggesting that we should also widen access to a range of other groups, including children under 5 years and school aged children. These previous consultation responses are summarised in the notification of that decision.
Te Whatu Ora and the Public Health Agency have advised us that influenza illness could again put additional strain on the health sector this winter when the sector is still expected to be under pressure managing hospitalisations from COVID-19.
Widened access for these groups of people for 2023 is in the context of managing the impact on the health sector by reducing hospitalisations when the health sector is expected to be under pressure managing COVID-19 cases and influenza admissions. Decisions on widened access to influenza vaccine in future years would need to be considered separately with consideration given to any issues facing the health sector and other funding options that Pharmac may be considering at the time.
Māori and Pacific peoples from 55 to 64 years of age
Many Māori and Pacific peoples from 55 to 64 years of age may already be eligible for funded influenza vaccine if they have other serious health conditions such as asthma, diabetes, or heart disease.
Access to funded influenza vaccine at a younger age for all Māori and Pacific peoples will mean that more Māori and Pacific peoples could benefit, noting that a smaller proportion of these populations is aged 65 years or older (the age at which influenza vaccine is funded for all population groups), compared to other population groups.
We estimate that an additional 39,000 Māori and Pacifc peoples aged 55-64 years will be eligible to receive funded influenza vaccine from 1 April 2023.
Children 6 months to 12 years of age
Widened access for children 6 months to 12 years is expected to reduce the impact of influenza for these children this year, and also reduce the spread of influenza to their whānau, who may be at risk from influenza themselves.
We estimate that an additional 835,000 children will be eligible to benefit from this decision from 1 April 2023, including approximately 370,000 children who are Māori or of any Pacific ethnicity.
Tamariki under 9 years of age who have not previously received flu vaccine will need two doses given four weeks apart to gain full immunity for 2023.
Who we think will be most interested
- Caregivers and whānau of children 6 months to 12 years of age
- Māori and Pacific peoples from 55 to 64 years of age and their whānau and families
- Healthcare professionals involved in immunisation
- Te Whatu Ora hospitals
- Suppliers and wholesalers
- Organisations with an interest in child health
- Organisations with an interest in Māori and Pacific health
- Organisations with an interest in immunisation
Detail about this decision
From 1 April 2023, funded access to the influenza vaccine will be widened to include Māori and Pacific peoples from 55 to 64 years of age; and children from 6 months to 12 years of age. The widened access is only for the 2023 calendar year.
The following changes to influenza vaccine eligibility criteria will occur in Section I of the Pharmaceutical Schedule (additions in bold, deletions in strikethrough):
A. INFLUENZA VACCINE – people 3 years and over
is available each year for patients aged 3 years and over who meet the following criteria, as set by Pharmac:
a. all people 65 years of age and over; or
b. people 55 to 64 years of age (inclusive) who are Māori or of any Pacific ethnicity, from 1 April 2023 to 31 December 2023; or
c. people under 65 years of age who:
i. have any of the following cardiovascular diseases:
a. ischaemic heart disease, or
b. congestive heart failure, or
c. rheumatic heart disease, or
d. congenital heart disease, or
e. cerebrovascular disease; or
ii. have either of the following chronic respiratory diseases:
a. asthma, if on a regular preventative therapy, or
b. other chronic respiratory disease with impaired lung function; or
iii. have diabetes; or
iv. have chronic renal disease; or
v. have any cancer, excluding basal and squamous skin cancers if not invasive; or
vi. have any of the following other conditions:
a. autoimmune disease, or
b. immune suppression or immune deficiency, or
c. HIV, or
d. transplant recipients, or
e. neuromuscular and CNS diseases/disorders, or
f. haemoglobinopathies, or
g. are children on long term aspirin, or
h. have a cochlear implant, or
i. errors of metabolism at risk of major metabolic decompensation, or
j. pre and post splenectomy, or
k. Down syndrome, or
vii. are pregnant; or
d. children 3 and 4 years of age (inclusive) who have been hospitalised for respiratory illness or have a history of significant respiratory illness; or
e. people under 65 years of age who:
i. have any of the following serious mental health conditions:
a. schizophrenia; or
b. major depressive disorder; or
c. bipolar disorder; or
d. schizoaffective disorder; or
ii. are currently accessing secondary or tertiary mental health and addiction services; or
f. children 3 to 12 years of age (inclusive), from 1 July 2022 1 April 2023 to 31 December 2022 31 December 2023;
Unless meeting the criteria set out above, the following conditions are excluded from funding:
a. asthma not requiring regular preventative therapy,
b. hypertension and/or dyslipidaemia without evidence of end-organ disease.
B. Contractors will be entitled to claim payment for the supply of influenza vaccine to patients eligible under the above criteria pursuant to their contract with Heath NZ for subsidised immunisation, and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule.
C. Contractors may only claim for patient populations within the criteria that are covered by their contract, which may be a sub-set of the population described in paragraph A above.
A. INFLUENZA VACCINE – child aged 6 months to 35 months
is available each year for patients aged 6 months to 35 months who meet the following criteria, as set by Pharmac:
- all children aged 6 months to 35 months from 1 April 2023 to 31 December 2023.
i. have any of the following cardiovascular diseases:
a. ischaemic heart disease, or
b. congestive heart failure, or
c. rheumatic heart disease, or
d. congenital heart disease, or
e. cerebovascular disease; or
ii. have either of the following chronic respiratory diseases:
a. asthma, if on a regular preventative therapy, or
b. other chronic respiratory disease with impaired lung function; or
iii. have diabetes; or
iv. have chronic renal disease; or
v. have any cancer, excluding basal and squamous skin cancers if not invasive; or
vi. have any of the following other conditions:
a. autoimmune disease, or
b. immune suppression or immune deficiency, or
c. HIV, or
d. transplant recipients, or
e. neuromuscular and CNS diseases/disorders, or
f. haemoglobinopathies, or
g. on long term aspirin, or
h. have a cochlear implant, or
i. errors of metabolism at risk of major metabolic decompensation, or
j. pre and post splenectomy, or
k. down syndrome, or
vii. have been hospitalised for respiratory illness or have a history of significant respiratory illness.
Unless meeting the criteria set out above, the following conditions are excluded from funding:
a asthma not requiring regular preventative therapy,
b hypertension and/or dyslipidaemia without evidence of end-organ disease.
B. Doctors are the only Contractors entitled to claim payment for the supply of influenza vaccine inj 30 mcg in 0.25 ml syringe (paediatric quadrivalent vaccine) to patients eligible under the above criteria pursuant to their contract with Heath NZ for subsidised immunisation, and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule.
The following changes to influenza vaccine eligibility criteria will occur in Part II of Section H of the Pharmaceutical Schedule (additions in bold, deletions in strikethrough, only changed criteria shown):
Restricted
Initiation - People of Māori or any Pacific ethnicity
People 55 to 64 years of age (inclusive) who are Māori or of any Pacific ethnicity, from 1 April 2023 to 31 December 2023.
Initiation – children from 3 to 12 years of age (inclusive)
Children 3 to 12 years of age (inclusive) from 1 July 2022 1 April 2023 to 31 December 2022 31 December 2023.
Restricted
Initiation – children 6 months to 35 months of age
Children 6 months to 35 months of age (inclusive) from 1 April 2023 to 31 December 2023.
Initiation – cardiovascular disease for patients aged 6 months to 35 months
Any of the following:
- Ischaemic heart disease; or
- Congestive heart failure; or
- Rheumatic heart disease; or
- Congenital heart disease; or
- Cerebro-vascular disease.
Note: hypertension and/or dyslipidaemia without evidence of end-organ disease is excluded from funding.
Initiation – chronic respiratory disease for patients aged 6 months to 35 months
Either:
- Asthma, if on a regular preventative therapy; or
- Other chronic respiratory disease with impaired lung function.
Note: asthma not requiring regular preventative therapy is excluded from funding.
Initiation – Other conditions for patients aged 6 months to 35 months
Any of the following:
- Diabetes; or
- chronic renal disease; or
- Any cancer, excluding basal and squamous skin cancers if not invasive; or
- Autoimmune disease; or
- Immune suppression or immune deficiency; or
- HIV; or
- Transplant recipient; or
- Neuromuscular and CNS diseases/ disorders; or
- Haemoglobinopathies; or
- Is a child on long term aspirin; or
- Has a cochlear implant; or
- Errors of metabolism at risk of major metabolic decompensation; or
- Pre and post splenectomy; or
- Down syndrome; or
- Child who has been hospitalised for respiratory illness or has a history of significant respiratory illness.
Implementation of changes to the National Immunisation Schedule
Te Whatu Ora and the Public Health Agency have told us they support widening of influenza eligibility for the 2023 season. The National Immunisation Programme will work with the health sector, including pharmacy, to communicate the eligibility change. Recent amendments to the Medicines Regulations 1984 mean that pharmacists can vaccinate people from 3 years of age and older. It is expected that pharmacists will be a key provider for vaccinating people who meet the widened criteria.
About influenza vaccine
Influenza can be a serious illness that is sometimes fatal. Infection with the influenza virus may lead to a stay in hospital for people of any age, but particularly for the elderly or those with an ongoing medical condition. Influenza can worsen existing medical conditions such as asthma or diabetes.
Influenza vaccine is funded each year for a range of people, including those 65 years and older, in pregnancy, and for people with medical conditions such as heart disease, respiratory conditions, diabetes, renal disease, and autoimmune diseases. Over 1.4 million people are usually vaccinated annually (funded and privately purchased).
The Afluria Quad and Afluria Quad Junior are the only funded influenza vaccines for the 2023 season and this decision relates to the use of both these vaccines. They are quadrivalent vaccines, which means they protect against four strains of influenza virus. For the 2023 season, the strains included are: A/Sydney, A/Darwin, B/Austria and B/Phuket.
If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.